Cryoablation: a novel approach to neurolysis of the ganglion impar.

Abstract

THE ganglion impar (also known as the ganglion of Walther) is a solitary retroperitoneal structure at the caudal end of the sympathetic chain. Blockade of this ganglion has been advocated as a means for managing intractable perineal pain. Chemical neurolysis has been the technique of choice for therapeutic neurolytic blockade of the ganglion impar because of a lack of viable alternative techniques. 1 The use of cryoablation for neurolysis of the ganglion impar has not been heretofore reported. Using a novel technique, a patient with perineal pain after rectal surgery for removal of tumor received successful long-lasting pain relief without adverse sequelae from cryoablation of this ganglion. This report demonstrates that cryoanalgesic lesioning of the ganglion impar is efficacious using the technique reported here.